Published: Saturday, May 25, 2013 at 5:30 a.m.

Last Modified: Saturday, May 25, 2013 at 7:48 a.m.

PORT ORANGE — The news that Jessica and Marco Falletta were expecting four girls — quadruplets — did not come with good odds.

Facts

The Falletta Quads by the Numbers

— Bottles per day: 24 to 30— Diapers per day: 30 to 40— Days in the NICU: Gianna 75; Isabella 75; Alexis 80; Natalia 113— Average daily cost of NICU per baby: $5,000— Average hours of sleep for parents per night: 2 to 4

SOURCE: Jessica and Marco Falletta

To helpThe Falletta's are accepting donations for formula and diapers for their babies. To donate, visit https://www.giveforward.com/fundraiser/wv32/supportforthefallettafamily

The couple's shock quickly turned to anxiety when doctors explained the risks of giving birth to quadruplets.

"Doctors gave us an 80 percent chance that I would give birth before 28 weeks and told us that with four babies, it was almost a guarantee that at least one would have severe health problems for the rest of their lives," Jessica, 29, said.

The next several months involved gut-wrenching decisions, faith and unexpected miracles.

Now, watching her 4-month-old quadruplets sleeping peacefully in their Port Orange home this week, Jessica said she would do it all over again.

"Having them all home was worth everything that we went through — all the hard days, hard nights and backaches."

Isabella, Gianna, Natalia and Alexis were born 12 weeks early at Baptist Medical Center in Jacksonville on Jan. 22. The sisters' birth weights were 2.5 pounds or less, with the smallest baby, Natalia, weighing 1.5 pounds.

After several months in the neonatal intensive care unit at Wolfson Children's Hospital in Jacksonville, the family was reunited when Natalia, the last baby to be released from the hospital, came home on May 15.

"Traveling to Jacksonville and working took its toll on me and Jessica," Marco, 38, said recently. "But it's a relief to know that they are all OK. We are really happy. I feel like our family is complete."

THE NEW NORMAL

The Falletta's living room resembles a day care, with four bassinets, four rockers, a changing table and baby toys scattered around. The days and nights often blur together for the parents who now get two to four hours of sleep each night. When one baby is settled, another one cries. There is always a diaper to change or a mouth to feed.

"There are days at 4 a.m. when I am not a happy camper," Jessica said. "They are all crying and they all need something and I feel like I can't duplicate myself four times."

Last month, Jessica returned to her job at Halifax Health Medical Center as a night nurse, but recently took more time off while the family adjusts to having all four babies at home. Marco, co-owner of DeVinci's Italian Restaurant and Pizzeria in Ormond Beach, works days.

Jessica's mother, Cathy Tetu, and Marco's mother, Enza Falletta, are on hand most days to help. The couple has also hired Dee Franks, a retired nurse, to help with the babies.

Prepping more than 30 bottles, changing dozens of diapers and soothing crying babies fill the majority of their days. Jessica hasn't attempted an outing with all four of her daughters, but she expects it will involve an entourage of caretakers and gawking strangers.

To prevent burnout or feeling overwhelmed, Jessica and Marco try to avoid caring for more babies than there are arms available. And they are still wrestling with the financial strain that comes with going from a family of two to a family of six.

"Everything we have to buy, we have to multiply it by four," Jessica said. "A cute $20 outfit becomes an $80 outfit."

RISK VS. REWARDS

After several failed attempts to start a family, the Falletta's spent $13,000 — the majority of their savings — on in-vitro fertilization. With a 60 percent chance of the treatment resulting in one pregnancy, they were overjoyed at the sight of a positive pregnancy test. But the couple never expected a sonogram would reveal four heartbeats.

During IVF, a woman is given hormones to produce multiple eggs, which are then retrieved, fertilized and transferred back to the uterus. The more embryos transferred increases the likelihood for multiple births.

Over the last decade the number of multiple births resulting from fertility treatments has decreased, largely due to revised medical guidelines that call for fewer embryos to be implanted back into a healthy woman's uterus. In 2010, 313 sets of quadruplets were born in the United States, according to the Centers for Disease Control and Prevention.

Jessica had two embryos implanted. One embryo split twice, resulting in identical triplets Isabella, Gianna and Natalia; the other produced their fraternal sister, Alexis.

While chances of multiple twinning from a single embryo are slightly higher through IVF, the Falletta's case is highly unusual, said Dr. Michael Freeman, a fertility specialist at the Florida Institute for Reproductive Medicine in Daytona Beach.

"That's very rare," he said. "It's hard to put a number on it but the chances of a single embryo transfer that results in triplets (and a fraternal sister) is going to be less than 1 percent."

'THE HARDEST DECISION TO MAKE'

As well as being rare, the Falletta's pregnancy had an increased risk of severe complications for the babies and Jessica. Doctors told her there was a high risk her uterus could rupture and advised her to reduce the number of babies. Because Gianna, Isabella and Natalia shared one placenta and were at the highest risk for complications, doctors suggested the pregnancy be reduced from four babies to one.

"That was probably the hardest decision to make," Jessica said. "I didn't want to be responsible for bringing four babies into the world who would suffer and have health problems for the rest of their lives."

Taking their doctor's advice, the Fallettas traveled to Virginia for the procedure. But an ultrasound there revealed the placenta supporting Alexis blocked access to the triplets, making it impossible for the doctors to perform the procedure.

"We felt relieved," Jessica said. "It felt like it was out of our hands. God had a different plan."

Twelve weeks into her pregnancy, Jessica said she could no longer work. She lost her insurance and went on Medicaid, the federal and state insurance program for the poor.

Jessica's due date was April 13 but she went into premature labor on Jan. 22. The babies were delivered at Baptist Medical Center in Jacksonville because its adjoining children's hospital, Wolfson, has a level-three NICU for high-risk births.

The tiny quads required oxygen and feeding tubes so they could grow strong, and Natalia needed two surgeries to repair intestinal blockage. Jessica stayed at the Ronald McDonald House Charities of Jacksonville for several weeks so she could be with the babies every day. Slowly they became stronger. Gianna and Isabella came home April 7, followed by Alexis on April 12. Natalia arrived home May 15.

On Wednesday, the quads turned 4 months old. It was a milestone that their parents didn't know they'd ever see.

"I am so grateful for what we have now and how precious they are," Marco said. "Ever since this pregnancy began, I've probably had more stressful days than I've had in my entire life. But whenever I am feeling bad, I pull out my phone and look at pictures of my babies and all I do is smile."

The Falletta's are accepting donations for formula and diapers for their babies. To donate, visit https://www.giveforward.com/fundraiser/wv32/supportforthefallettafamily

The Falletta Quads by the Numbers

— Bottles per day: 24 to 30

— Diapers per day: 30 to 40

— Days in the NICU: Gianna 75; Isabella 75; Alexis 80; Natalia 113

— Average daily cost of NICU per baby: $5,000

— Average hours of sleep for parents per night: 2 to 4

SOURCE: Jessica and Marco Falletta

All rights reserved. This copyrighted material may not be re-published without permission. Links are encouraged.